Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
CH046900 MEDCURA HEALTH, INC.

Covered Entity Details

Entity Name

MEDCURA HEALTH, INC.

Subdivision Name

STONE MOUNTAIN

Type

HRSA-Funded Health Center

340B ID

CH046900

Entity Address

5582 MEMORIAL DRIVE
STONE MOUNTAIN, GA 30083

Grant Number

H80CS00179

Participating Start Date

4/1/2004

Last Recertification Date

2/16/2025

Pharmacy Details

Pharmacy Name

PROCARE PHARMACY, L.L.C.

Pharmacy Address

DBA CVS/PHARMACY #2923
3250 HARDEN ST. EXT. SUITE #300
COLUMBIA, SC 29203

Pharmacy Comments

Contract Details

Approval Date

7/7/2021

Contract Begin Date

10/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/21/2022
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Jeff Taylor, Chief Executive Officer
(404) 298-3250

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

7/7/2021

340B Drug Pricing Program Database